California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews while working remotely.
Key responsibilities
- Conduct coding validation, documentation review, and data-driven analysis to ensure accurate risk capture and regulatory compliance
- Develop compliance reports by evaluating compliance data and audit information, summarizing potential risks and remedies
- Collaborate with internal and external stakeholders to design and implement strategic compliance initiatives and monitor adherence to regulations
Required qualifications
- Minimum four (4) years of medical coding experience
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field with at least six (6) years of relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
Complete Job Description
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